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Individual

AMANDA NICOLE HOLLOWAY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4181 SW HIGH MEADOWS AVE, PALM CITY, FL 34990-3725
(772) 222-5560
(844) 652-8088
Mailing address
4274 SW KAZAN ST, PORT SAINT LUCIE, FL 34953-7247
(772) 812-5225

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
FL

Other

Enumeration date
02/11/2020
Last updated
02/11/2020
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